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A04.72
ICD-10-CM
C. diff diarrhea

Learn about C. diff diarrhea diagnosis, including clinical documentation and medical coding for Clostridioides difficile infection (CDI) and C. difficile colitis. This resource provides information on antibiotic-associated diarrhea, supporting healthcare professionals with accurate and efficient diagnostic coding and documentation best practices. Understand the key symptoms and diagnostic criteria for C. diff infection to ensure proper patient care and appropriate medical coding.

Also known as

Clostridioides difficile infection
C. difficile colitis
Antibiotic-associated diarrhea

Diagnosis Snapshot

Key Facts
  • Definition : Infection causing inflammation of the colon, often after antibiotic use.
  • Clinical Signs : Watery diarrhea, abdominal pain, fever. Severe cases can lead to toxic megacolon.
  • Common Settings : Hospitals, long-term care facilities, after antibiotic treatment.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC A04.72 Coding
A04.7

Enterocolitis due to Clostridium difficile

Diarrhea caused by C. difficile bacteria.

A00-A09

Intestinal infectious diseases

Infections affecting the intestines, including bacterial and viral causes.

K52

Noninfective gastroenteritis and colitis

Inflammation of the stomach and intestines not caused by infection.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the C. diff infection confirmed?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Diarrhea caused by C. diff bacteria.
Diarrhea not related to C. diff.
Inflammation of the colon, not by C. diff.

Documentation Best Practices

Documentation Checklist
  • Document antibiotic use within 2 months prior to onset.
  • Describe diarrhea frequency, consistency, and presence of blood.
  • Record positive C. difficile lab test (e.g., PCR, toxin assay).
  • Document signs/symptoms: abdominal pain, fever, dehydration.
  • Specify disease severity: mild, moderate, severe, fulminant.

Coding and Audit Risks

Common Risks
  • Unspecified CDI

    Coding C. diff without specifying if it's initial or recurrent episode leads to inaccurate severity and quality reporting. Use A04.71 or A04.72 appropriately.

  • Missed CDI Diagnosis

    Overlooking documentation of antibiotic-associated diarrhea or C. difficile colitis can lead to undercoding and missed reimbursement. Review clinical notes carefully.

  • Incorrect POA Assignment

    Inaccurate present on admission (POA) indicator for CDI impacts hospital-acquired infection reporting and quality measures. Ensure proper POA assignment.

Mitigation Tips

Best Practices
  • Isolate C. diff patients. Use contact precautions.
  • Proper hand hygiene. Soap and water preferred over alcohol.
  • Disinfect with sporicidal agents. EPA-approved list.
  • Antibiotic stewardship. Limit unnecessary antibiotic use.
  • Accurate CDI diagnosis coding. ICD-10: A04.7

Clinical Decision Support

Checklist
  • Recent antibiotic use? Document type and duration.
  • ≥3 loose stools in 24 hours? Document stool characteristics.
  • Consider C. diff testing: PCR, GDH, toxin assay. Document indication.
  • Positive C. diff test? Isolate & start appropriate therapy. Document.
  • Assess for disease severity: WBC, creatinine. Document risk factors.

Reimbursement and Quality Metrics

Impact Summary
  • C diff diarrhea reimbursement impacted by accurate ICD-10-CM coding (A04.7).
  • Coding quality affects C diff infection MS-DRG assignment and hospital payments.
  • Proper CDI documentation improves C diff colitis severity capture for optimal reimbursement.
  • Accurate C diff reporting impacts hospital-acquired infection metrics and value-based purchasing.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes. Our AI-powered assistant ensures compliance and reduces coding errors.

Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective C. diff treatment guidelines for recurrent Clostridioides difficile infection in adults?

A: Recurrent Clostridioides difficile infection (CDI) is a significant clinical challenge. Current treatment guidelines recommend a fidaxomicin regimen for the first recurrence, given its efficacy in preventing further recurrences. For subsequent recurrences or in cases where fidaxomicin is unavailable, a tapered and pulsed vancomycin regimen is recommended. Fecal microbiota transplantation (FMT) is considered a highly effective treatment option for multiple recurrences, demonstrating high cure rates and offering a solution for patients who have failed standard antibiotic therapies. Bezlotoxumab, a monoclonal antibody targeting C. difficile toxin B, can also be considered as an adjunctive therapy to standard antibiotics to reduce the risk of recurrence. Explore how antibiotic stewardship programs can play a critical role in preventing CDI, particularly in hospital settings.

Q: How can I differentiate between C. diff diarrhea and other causes of antibiotic-associated diarrhea in my patients?

A: Differentiating Clostridioides difficile infection (C. diff) from other causes of antibiotic-associated diarrhea (AAD) requires a multi-pronged approach. While AAD can result from various factors like disruption of the gut microbiome or direct antibiotic effects, C. diff diarrhea is specifically caused by the toxins produced by C. difficile. Clinical suspicion for CDI should be raised when a patient presents with diarrhea during or after antibiotic use, especially if accompanied by symptoms like abdominal pain, fever, or leukocytosis. Laboratory testing, primarily stool tests for C. difficile toxins, is essential for confirming the diagnosis. Polymerase chain reaction (PCR) testing for C. difficile genes is highly sensitive but can be positive even in colonized patients without active infection. Therefore, combining PCR with toxin testing or using a multi-step algorithm helps improve diagnostic accuracy. Consider implementing diagnostic algorithms that incorporate clinical factors and laboratory results for accurate and timely diagnosis of CDI. Learn more about the importance of prompt diagnosis in managing CDI and minimizing its complications.

Quick Tips

Practical Coding Tips
  • Code C. diff diarrhea as A04.7
  • Document antibiotic use for A04.7
  • Consider colitis codes if documented
  • Query physician for C. diff severity

Documentation Templates

Patient presents with complaints consistent with Clostridioides difficile infection (CDI), also known as C. diff diarrhea or antibiotic-associated diarrhea.  Onset of symptoms, including watery diarrhea, abdominal pain, and cramping, began approximately [Number] days ago following a recent course of [Antibiotic Name] prescribed for [Underlying condition].  The patient reports [Number] bowel movements per day, characterized by loose, foul-smelling stools.  Review of systems reveals associated symptoms such as nausea, anorexia, and fatigue.  Physical examination demonstrates mild abdominal tenderness with no rebound or guarding.  Vital signs are as follows: temperature [Temperature], heart rate [Heart rate], blood pressure [Blood pressure], respiratory rate [Respiratory rate], and oxygen saturation [Oxygen saturation].  Based on the clinical presentation and recent antibiotic use, C. difficile colitis is suspected.  Stool studies for C. difficile toxin are ordered.  Differential diagnoses include other infectious causes of diarrhea, inflammatory bowel disease, and irritable bowel syndrome.  Initial management includes discontinuation of the inciting antibiotic, if feasible, and initiation of empiric therapy with [Treatment medication] as per guidelines for C. difficile treatment.  Patient education provided on contact precautions, hygiene measures, and the importance of completing the full course of prescribed medication.  Follow-up appointment scheduled in [Number] days to assess treatment response and monitor for complications such as dehydration and pseudomembranous colitis.  ICD-10 code A04.7 for C. difficile colitis is documented.  Further diagnostic workup may be indicated if the patient does not respond to initial therapy.